Congratulations to our NICU Family Integrated Care team, which has won a regional award for a new Quality Improvement (QI) project aimed at providing improved comfort and pain relief in neonatal babies.
Building on existing research from University College London Hospital (UCLH), the team has introduced new measures into the Hull NICU which are designed to support babies with non-pharmaceutical pain relief during procedures.
Prepare, Support, Protect: Reducing Procedural Pain – Identifying Barriers, Enhancing Parental Involvement and Building a National Collaboration, focuses on improving the way neonatal staff and parents work together, using techniques such as skin-to-skin, breast milk, swaddling and sucrose to help minimise pain.
The research and national guidance was already there to support the benefits of these techniques in terms of pain management, so the team’s focus was on how we could make it easier for them to be used routinely when carrying out procedures.
And, after presenting the results at the Yorkshire and Humber Neonatal Operational Delivery Network Conference, the team was awarded the first prize for best QI Project.
Consultant Neonatologist, Dr Ourania Pappa – who led the Multidisciplinary Team undertaking the work – said: “This has been a whole change of mindset from doing everything that we need to do medically, to actively getting parents involved when doing procedures and ensuring that they are directly involved in the care of their babies, as much as they would like to be.
“We started implementing this with our less poorly patients, working with staff and parents to make small changes which help to support this – such as standardising the times we carry out blood tests to make it easier for parents to arrange to be there.
“Throughout the project, we have also regularly surveyed staff and patients and used the information we have gathered to make further improvements.”
Neonatal Feeding Support Lead, Rachael Dunhill, added: “Another benefit has been that it’s opening more discussions with parents – they are becoming more comfortable about giving us feedback about their overall experience and we’re developing a better rapport.”
For some parents it can be hard when their babies are being cared for in NICU, feeling there’s not much they can do to help in their care. However, this initiative is helping to break down those barriers.
Rachael said: “We have found that the parents realise just how important to their babies’ lives they are. Some don’t think that they are the best for them – that the best thing for their care is the incubator or the specialist care we provide as nurses – but they are just as important.
“Things like having their parents there soothing them or being held skin-to-skin when undergoing procedures helps the babies through it. It also gives the parents a greater understanding of the tests and the importance of them, as well as giving them a voice. Their voice and opinion is really important – they know their babies and when they need a break.”
Dr Pappa highlighted that parental comfort measures not only reduce distress but also support babies’ neurodevelopment.
She said: “There are two main approaches to managing pain in babies: pharmacological and non-pharmacological. While medications play an important role when needed, evidence shows that simple measures such as parental involvement and skin-to-skin care can be highly effective. By reducing the need for medication where appropriate, we can improve outcomes and enhance the overall care experience for babies and their families.
“There are significant benefits to non-pharmaceutical methods. Lower stress leads to improved brain growth, and by using these techniques to reduce pain, we also reduce crying and reduce stress.
“Many thanks to the rest of the QIP team: Anna Smith, Claire Douglas, Akshaye Patel, Huwaida Fazel and our Discharge Assistant, Lisa Walters. This project would not have been possible without their enthusiasm and dedication.
“We are also incredibly grateful to all the NICU staff for embracing the project and demonstrating a continued commitment to improving the experience and outcomes of babies and families.”